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once the decision to admit a patient has been made, it is appropriate to perform a physical examination to determine the patients’ overall health. the physical examination includes a patient assessment of the cardiovascular and respiratory systems. the following questions are asked to the patient during the physical examination.
most echocardiographic exams are performed using a m-mode echocardiograph, which provides sub-costal and apical views of the heart. it is normal to feel the heart tapping against the rib cage when the m-mode is used. the subjective nature of the heart sound provides the clinician with a valuable reference point with which to interpret the spectral waveform information. echocardiography is typically performed using a precordial or esophageal stethoscope (see below for a discussion of different types of stethoscopes) and a m-mode echocardiograph. the precordial stethoscope is used to record the heart sounds and the esophageal stethoscope is used to record the auscultable sounds such as s1, s2 and their first, second and third reflections. however, it is important to realize that the precordial stethoscope has some inherent limitations. the first is that it can only record the sounds emanating from the chest, not those emanating from the lung. the second is that the heart sounds are recorded at the precordial site and as such, are potentially affected by conduction delay. the third is that the precordial stethoscope cannot record the auscultable sounds from the carotid sinus, aortic arch and carotid bulb. the esophageal stethoscope can record all the auscultable sounds (e.g. s1, s2 and their first, second and third reflections) and in addition, can simultaneously record the heart sound from the chest. this is done by having the stethoscope be positioned in the upper esophageal sphincter and by having a second set of ear tips attached to the esophageal stethoscope which is positioned within the esophagus. the second ear tips are designed to simultaneously act as the outer ear and as the internal ear in order to eliminate the delay which can occur between the external and internal acoustic ears (see figure 1).
the journal publishes original articles, reviews, letters, case reports and guest-edited single topic issues in all areas of experimental and clinical research in anesthesia, pharmacokinetics, anesthetic mechanisms, critical care, preoperative care, clinical skills, cost issues, coexisting disease and other factors affecting treatment with an academic degree. it also publishes editorials, news items and announcements.
open anesthesia journal publishes original research articles, reviews, letters, case reports and guest-edited single topic issues in all areas of experimental and clinical research in anesthesia, pharmacokinetics, anesthetic mechanisms, critical care, preoperative care, clinical skills, cost issues, coexisting disease and other factors affecting treatment with an academic degree. it also publishes editorials, news items and announcements.
bentham open publishing is a part of the bentham science publishers and is dedicated to publishing peer-reviewed manuscripts in all areas of research and quality improvement in the field of healthcare. the editorial team of open anesthesia journal has a wealth of experience in reviewing articles and in management and organization of research papers and projects. the team also has a team of experts, who provide guidance in management of all types of papers. the editorial team of open anesthesia journal ensures swift peer review process and accepted papers are published within 2 weeks of final acceptance.
the editorial team of open anesthesia journal has a wealth of experience in reviewing articles and in management and organization of research papers and projects. the team also has a team of experts, who provide guidance in management of all types of papers. the editorial team of open anesthesia journal ensures swift peer review process and accepted papers are published within 2 weeks of final acceptance.
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